REMARKS BY DR.FIDEL CASTRO RUZ, PRESIDENT OF THE REPUBLIC OF CUBA, AT THE 10TH IBERO-AMERICAN SUMMIT. PANAMA CITY, 17-18 NOVEMBER, 2000.

Her Excellency Mrs. Mireya Moscoso;

Your Majesty;

Excellencies;

Distinguished guests:

It was a happy initiative to adopt "United for childhood and adolescence, the basis of justice and equity in the new millenium", as the central issue of this summit conference. That idea alone would suffice to give meaning to this significant gathering. Thus, I wish to congratulate Mrs. Mireya Moscoso, President of the host country.

The situation of children is different in every one of our nations. Despite progress made in the last two decades, partly due to the relevant initiatives promoted and the tenacious efforts undertaken by UNICEF, the WHO and other UN agencies --more or less warmly received and supported by the national governments, taking into account the disparities in development and resources among nations-- life for Latin American children in general is really dramatic.

The 45% of the total population in Latin America and the Caribbean region are poor, that is, 224 million people, and 90 million of them live in absolute poverty. Actually, over half of the poor and absolute poor are children and adolescents.

As indicated by the UN Children Fund: "Children are more severely affected by poverty. No other age group is as vulnerable since the physical and psychological damages they sustain affect them for life".

According to data from the Pan American Health Organization, acute respiratory infections, diarrhea and nutritional deficiency persist as the three main causes of death for children under 5 years of age.

The average mortality rate for children under 5 years of age in Latin America and the Caribbean region was 39 per 1000 live births in 1998, thus, the number of dead children was close to half a million.

Acute respiratory infections, such as influenza and pneumonia, are the cause of one third of all deaths among children under 5 in the region; close to 60% of pediatric consultations are related to them and most of the resulting deaths can be prevented by a timely diagnosis and adequate treatment.

Between 20 and 50 percent of the urban population in the region live in dreadful conditions of massive overcrowding, extreme poverty, violence and marginalization; they do not have access to basic primary health care or sewage services; in the rural areas over 60% do not have these services and 50% also lack drinking water. The absence of adequate systems of sewage services, drinking water supplies and medical care raises by over 40% the risk of death from diarrhea, cholera, typhoid fever and other transmissible diseases.

Food and nutritional deficiencies impact on children’s defense mechanisms increasing exponentially their sensitivity to non-transmissible chronic diseases. The ECLA has estimated that this year 2000, approximately 36 percent of all children under 2 years of age are in a high risk food situation which is worse still in the rural areas where about 46 percent are in jeopardy due to generally precarious sanitation conditions and greater difficulties to gain access to public health care.

The poor segments of the population are affected by illnesses associated to deprivation; in the case of vitamin A deficiency, which is considered one of the main causes of blindness, it affects millions of children under 5 years of age in the region.

The direct cost of vaccines for the immunization of a child under one year of age against six preventable child diseases such as diphtheria, measles, whooping cough, poliomyelitis, tuberculosis and tetanus is lower than 80 cents of a US dollar. However, the World Health Organization has reported that all over the area of the Americas, including the United States and Canada, immunization coverage of children under one year against these diseases ranges from 85 to 90 percent, thus it is estimated that over 15 million children in the hemisphere, under 5 years of age, are not protected from those six diseases.

The average maternal death for Latin America and the Caribbean region amounts to 200 per 100,000 births while in the developed nations the figure is about 15. Therefore, in our region, no less than 50,000 children are motherless due to this cause only. Moreover, for every dead mother hundreds of those who survive suffer from chronic problems resulting from undernourishment and inadequate care during pregnancy and delivery. Thus, millions of mothers suffer some kind of chronic health problem related to the absence of effectual medical care during pregnancy and delivery.

Two basic indicators, that is, infant and maternal mortality rates, show that every year 6.5 more children and 12.6 more mothers die in Latin America and the Caribbean region than in the developed nations per 1000 live births. On the other hand, of the 12 million children born very year, almost 2 million are born to adolescent mothers.

The HIV/AIDS keeps growing at a dangerous pace in the region and, according to data from UNAIDS, 1,700,000 people are already infected. UNICEF has indicated that 65,000 new children are infected every year, 90% of them by their own mothers. Consequently, the number of orphans due to this cause only is already 195,000. In Latin America and the Caribbean region over 78,000 people have died of AIDS.

As for education, it is estimated that 20% of children join the educational system late, 42% do not get through the first grade and 30% do not get through the second. Only 80% of children in the region make it to fourth grade and just 73% to the fifth. Eight out of every ten students attend school for seven years but the average schooling is approximately four grades. Pre-school education coverage in the region reaches an average of 15 percent.

Likewise, child labor expands like a real pest. Close to 20 million children under 15 years of age are working and over half of them are girls, most performing tasks that are neither recognized nor reported in the official statistics.

According to PAHO, violence has become one of the main causes of death among children 5 to 15 years old. Although exact figures on child abuse are not available, several studies conducted by UNICEF indicate that no less than 6 million children and adolescents are victims of severe aggressions and 80,000 of them die every year due to home violence.

A study conducted in 1996 by the World Conference on Sexual Exploitation revealed that the previous year 47 percent of girls sexually exploited in seven countries of the regions had been the victims of rape and violence at home. Almost half of these girls had been initiated in commercial sexual practices between the ages of 9 and 13, and from 50 to 80 percent of them were on drugs.

Hundreds of thousands of boys and girls work and live in the streets and in some capitals 46% of women involved in prostitution are under 16 years old.

I rather avoid here the political and economic causes of this tragedy since they are very familiar to you.

Finally, I would only add –as it is my duty-- that if infant mortality rate in the Latin American and Caribbean region were similar to the 6.4 per 1000 live births in the first year of life and the 8.3 for children under 5 reached by Cuba --despite the fact that it has been isolated, harassed and subjected to a ruthless economic warfare for over 40 years-- almost 400,000 children would have survived every year; 99.2% would have pre-school education coverage; 99.9% would be enrolled in school by the age of 6 and 99.7% would remain in school up to sixth grade. Also, 98.9% of the total first grade enrollment would have passed the sixth grade and 99.9% would have enter junior high school while 99.5% of these graduates would go on to senior high school or technical school. They could have obtained the first prizes in the Olympiads of Knowledge and there would not be children in need of special education without schools. Actually, there would not be illiterates and the average educational level of the adult population would be higher than the ninth grade; lastly, there would not be one child under 16 years of age working for a living.

Our tough experience has demonstrated that a lot can be done with very little resources.

To conclude, I wish to express my appreciation to all Heads of State and Government present here all of whom --with two exceptions-- voted for the Resolution against the blockade of Cuba adopted last November 9 at the United Nations General Assembly.